Individual provider Active NPI

Minkyung Shin, MD

  • Pediatrics Physician
  • Marysville, WA
National Provider Identifier
1437618790
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD61268633 Issued in WA
Practice address
4420 76TH St NE
Marysville, WA 98270-3726
Phone
(360) 651-7492
Fax
(360) 651-7482
NPI assigned
Mar 17, 2019
Last updated
May 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD61268633 WA Primary
Pediatrics Physician 208000000X PTL1523 CA

Addresses

Primary practice location

4420 76TH St NE
Marysville, WA 98270-3726

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221021001915 WA Practitioner - Pediatric Medicine 3274948781 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PTL1523CAMDPediatrics Physician
MD61268633WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC Pediatrics CurrentSince Sep 26, 2022 Accepting new patients
Optum Care Washington PLLC Pediatrics CurrentSince Sep 26, 2022 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

4420 76th St NE
Marysville, WA 98270
Phone (360) 651-7490

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: mshin68201@direct.tecmc.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1437618790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 76TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982703726",
            "telephone_number": "360-651-7492",
            "fax_number": "360-651-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "MINKYUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-17",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61268633",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "PTL1523",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.